Provider Demographics
NPI:1588659478
Name:SUSQUEHANNA VALLEY WOMEN'S HEALTH CARE PC
Entity Type:Organization
Organization Name:SUSQUEHANNA VALLEY WOMEN'S HEALTH CARE PC
Other - Org Name:THE WOMEN'S HEALTHCARE GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:J
Authorized Official - Last Name:LAWRENCE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:717-845-1621
Mailing Address - Street 1:1693 S QUEEN ST
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17403-4609
Mailing Address - Country:US
Mailing Address - Phone:717-845-1621
Mailing Address - Fax:717-718-9247
Practice Address - Street 1:1693 S QUEEN ST
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403-4609
Practice Address - Country:US
Practice Address - Phone:717-845-1621
Practice Address - Fax:717-718-9247
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SUSQUEHANNA VALLEY WOMEN'S HEALTH CARE PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-09-16
Last Update Date:2019-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAE12904Medicare UPIN
PAS34803Medicare UPIN
PAG49147Medicare UPIN
PAE12917Medicare UPIN
PAF59557Medicare UPIN
PAC28977Medicare UPIN